Complications of thyroid surgery

ABSTRACT

To determine the percentage of complications in thyroid surgery and compare these complications with the other national and international studies, Study Design: A descriptive study, The study was conducted in the department of Surgery, Foundation University Medical College and Fauji Foundation Hospital Rawalpindi from 1 [st] January 2009 to 31[st] December 2009. Patients and Methods: 192 patients above the age of 14 who consented were included in the study. General physical ansd loco regional examination was done in OPD. Thyroid function tests [T3, T4, and TSH] were done in all the patients besides other routine investigations. FNAC and thyroid scan was done in only selected patients. Anemia, hypertension and other comorbid condition, if present, were corrected and assessed by anesthetist in the pre admission clinic. Only euthyroid patients, both clinically and biochemically and fit for general anesthesia were admitted for operation. Subsequently all the patients were subjected for surgery and the specimens were sent for histopathology after visual examination. Pre as well as per operative findings were recorded on a specially designed proforma. The data were then entered in the computer for analysis and conclusions were drawn. Total of 192 patients operated for benign thyroid disease in year 2009. Age ranges between 14 to 80 with 120 patients below the age of 40. Out of 192 patients, only 6 were males.90 patients were operated for pressure symptoms, 78 for cosmetic reasons and 24 for toxic symptoms. Subtotal thyroidectomy was done in 132 patients while 24 patients ended up with near total and 36 were candidates for lobectomy. 6 patients had symptoms of RLN damage while 24 develop parathyroid insufficiency post operatively. All these patients managed conservatively and discharge on 2[nd] or 3[rd] post op day. They regain normal voice and normal serum calcium levels by the end of 3 months. Subtotal thyroidectomy is one of the commonest procedure done by the surgeons of Rawalpindi Islamabad region. Maximum effort should be done to optimize the patients preoperatively. If patients are euthyroid and assessed carefully for anesthesia fitness before operation, chances of per or post- operative complications are negligible